OCCURRENCE OF CARBAPENEMASES AND EXTENDED-SPECTRUM Î’ETA-LACTAMASES IN UROPATHOGENIC ENTEROBACTERIACEAE ISOLATED FROM A COMMUNITY SETTING, SETTAT, MOROCCO

Objective: Urinary tract infections (UTIs) are still commonly diagnosed in outpatients as well as in hospitalized patients. In this study, weinvestigated the prevalence and performed molecular characterization of extended-spectrum-β-lactamases (ESBL) and carbapenemases produced byEnterobacteriaceae isolates that cause community UTIs in Settat city, Morocco.Methods: From January 2012 to December 2013, all uropathogenic community Enterobacteriaceae isolates were collected from the microbiologylaboratory of Hassan II Hospital, Settat, Morocco. Antibiotic susceptibility testing was performed as recommended by Clinical and LaboratoryStandard Institute. Phenotypic identification of ESBL and carbapenemase producer isolates was confirmed by the double-disk synergy test and themodified Hodge test, respectively. Molecular characterization of β-lactamase genes was performed using polymerase chain reaction (PCR), followedby sequencing of the obtained products.Results: Among 153 isolates, 31 (20.26%) were multi-drug resistant (MDR). Nine strains (5.88%) were ESBL producers, of which Klebsiellapneumoniae (n=5; 20.83%), Escherichia coli (n=3; 3.15%), and Enterobacter cloacae (n=1; 9.09%) species were identified. The results of ESBLencodinggene detection by sequencing revealed the presence of CTX-M-15 (n=9) in association with other β-lactamase genes such as temoneira 1 (n=8) and sulfhydryl variable 1 (n=5). According to the modified Hodge test and PCR, three isolates (1.96%) were positive carry the blaConclusion: The emergence of MDR uropathogenic Enterobacteriaceae isolates in our community is highly alarming. Strict measures will be required to control the further spread of these uropathogenic isolates. Keywords: Carbapenemase, Enterobacteriaceae, Extended-spectrum-β-lactamases, Moroccan community.OXA-48 gene.Keywords: Carbapenemase, Enterobacteriaceae, Extended-spectrum-β-lactamases, Moroccan community.Objective: Urinary tract infections (UTIs) are still commonly diagnosed in outpatients as well as in hospitalized patients. In this study, we investigatedtheprevalenceandperformedmolecularcharacterizationofextended-spectrum-β-lactamases(ESBL)andcarbapenemasesproducedby Enterobacteriaceae isolates that cause community UTIs in Settat city, Morocco. Methods: From January 2012 to December 2013, all uropathogenic community Enterobacteriaceae isolates were collected from the microbiology laboratory of Hassan II Hospital, Settat, Morocco. Antibiotic susceptibility testing was performed as recommended by Clinical and Laboratory Standard Institute. Phenotypic identification of ESBL and carbapenemase producer isolates was confirmed by the double-disk synergy test and the modified Hodge test, respectively. Molecular characterization of β-lactamase genes was performed using polymerase chain reaction (PCR), followed by sequencing of the obtained products. Results: Among 153 isolates, 31 (20.26%) were multi-drug resistant (MDR). Nine strains (5.88%) were ESBL producers, of which Klebsiella pneumoniae (n=5; 20.83%), Escherichia coli (n=3; 3.15%), and Enterobacter cloacae (n=1; 9.09%) species were identified. The results of ESBL- encodinggenedetectionbysequencingrevealedthepresenceofCTX-M-15(n=9)inassociationwithotherβ-lactamasegenessuchastemoneira1 OXA-48 (n=8) and sulfhydryl variable 1 (n=5). According to the modified Hodge test and PCR, three isolates (1.96%) were positive carry the bla gene.  Conclusion:TheemergenceofMDRuropathogenicEnterobacteriaceaeisolatesinourcommunityishighlyalarming.Strictmeasureswillberequiredto control the further spread of these uropathogenic isolates. Keywords: Carbapenemase, Enterobacteriaceae, Extended-spectrum-β-lactamases, Moroccan community